U.S. drug deaths declined slightly in 2023 but remained at crisis levels

Updated Wednesday May 15 at 1:25 p.m. ET.

Preliminary data released Wednesday from the Centers for Disease Control and Prevention found fatal drug overdoses in the U.S. fell by roughly 3% in 2023.

That is a significant reversal from previous years, when street fentanyl and other toxic synthetic drugs including methamphetamines sparked an unprecedented surge in drug deaths.

But the toll from the overdose crisis in 2023 remained devastatingly high, claiming 107,543 lives.

That compares with 111,029 overdose deaths in 2022. Drug deaths in 2023 remained above the 106,699 fatalities recorded by the CDC in 2021.

Before the explosion of fentanyl and methamphetamine use, the U.S. suffered far fewer overdose deaths — roughly 53,356 fatalities, for example, in 2015.

"We are encouraged to see the preliminary data that shows a decrease in the overdose death rate for the first time in five years, especially following the period of rapid double-digit increases from 2019-2021," said White House drug control policy director, Dr. Rahul Gupta in a statement.

The CDC's chief medical officer Deb Houry noted in a statement that despite the decline, "there are still families and friends losing their loved ones to drug overdoses at staggering numbers." But she added, "progress over the last 12 months should make us want to reinvigorate our efforts knowing that our strategies are making a difference."

Synthetic pills continue to flood the U.S.

In a statement released last week as part of the U.S. National Drug Threat Assessment for 2024, the head of the Drug Enforcement Administration, Anne Milgram, said the overdose crisis remains perilous.

"The shift from plant-based drugs, like heroin and cocaine, to synthetic, chemical-based drugs, like fentanyl and methamphetamine, has resulted in the most dangerous and deadly drug crisis the United States has ever faced," Milgram said.

A separate report published Monday in the International Journal of Drug Policy found that fentanyl — often in the form of counterfeit prescription pain pills — continues to flood U.S. communities.

In 2023 alone, law enforcement seized more than 115 million fake pills.

"Availability of illicit fentanyl is continuing to skyrocket in the U.S., and the influx of fentanyl-containing pills is particularly alarming," said Joseph Palamar, an associate professor in the Department of Population Health at the NYU Grossman School of Medicine, who was the lead author on the study.

U.S. officials and drug policy experts say fentanyl is manufactured and smuggled largely by Mexican drug cartels using chemicals supplied by Chinese drug gangs.

Opioid deaths decline, but meth and cocaine claim more lives

The latest CDC data for 2023 shows that while fentanyl and other opioids remain the most deadly threat, other street drugs are becoming more dangerous.

The total number of fentanyl deaths actually declined modestly in 2023, dropping from 76,226 to 74,702. Meanwhile, fatal overdoses from psychostimulants (including methamphetamine) and cocaine, rose from 63,991 to 66,169.

Because many fatal overdoses involve multiple street drugs, the number of deaths attributed to specific substances do not "equal the total number of drug overdose deaths," according to the CDC.

This research also found uneven progress around the U.S. in curbing fatal overdoses.

Kansas, Indiana, Maine and Nebraska saw declines in drug deaths of 15% or more, the CDC reported. Other states had increases, including Alaska, Oregon and Washington, where drug deaths went up at least 27%.

Strategies aimed at curbing the overdose crisis have emerged as a political flashpoint, fiercely debated in Congress and in state capitals around the country.

Some states, including California and Oregon, have begun rolling back drug policies that were aimed at shifting the addiction response to a public health model and reducing the role of police.

But there are also few indications that tougher drug laws, heightened border security and increased drug seizures have made a significant dent in the increasingly toxic street drug supply.

In its latest report, the DEA found that "no field office [in the U.S.] reported that fentanyl is less available or more expensive, either of which would point to a decrease in the supply."

NPR's Emma Bowman and Martin Kaste contributed reporting.

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